I Have Heavy, Puffy Upper Eyelids. Are the Non-surgical Alternatives to Fix That?

Question

My upper eyelids are very heavy and puffy. It's not because of my age--I was born with these eyes:) I would like to find an alternative solution to the surgery.

Kenneth D. Steinsapir, MD · Answer

Dear Nklimovi

	Your heavy eyebrow is an important facial feature.  Cutting the upper eyelid skin actually causes the eyebrow to fall and is generally not ideal.  The best nonsurgical option for this is my patented microdroplet BOTOX forehead lift. Follow the link below for more information on this.  This is a nonsurgical forehead lift.  You also have a relatively prominent midcheek groove and midcheek/deep cheek filler would help restore youthfulness to your face.  I agree you do not need surgery at this time.

Stephen T. Greenberg, MD, FACS · Answer

Thank you nklimovi for your question.  Typically puffy upper lids can only be addressed with surgery because we need to remove the fat pocket and potentially extra skin.  There typically isn't much down time with the procedure and sutures are removed within 5-7 days.  Make a consult with a board certified surgeon to see if your a candidate for this procedure or if there is anything else that can be done.

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thank you for your question.  Botox would be a non surgical option to try and raise your eyebrow to make the appearance of less heaviness.  If you have loose skin and puffiness then surgery would the only option to remove.  Extra skin and fat on the upper eyelid can cause the eyes to feel and look tired. Taken to the extreme, the extra skin can hang so much that it can hamper your vision and cause discomfort. Eyelid surgery combined with Eyebag Removal can effectively reduce the excess skin from the upper and lower eyelids to leave you with wider more youthful looking eyes.  If you look tired when you're not, and can’t put eye shadow or mascara due to excess skin covering your eyelids, then you can benefit from upper eyelid lift or Upper Blepharoplasty.  Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  All The Best

Tanveer Janjua, MD · Answer

This is no easy solution to puffy eyelids which are congenital and not related to excess skin.  One of the few things that seems to work is the use of Thermismooth to tighten the skin and the underlying tissues which can reduce the puffy appearance.RegardsDr. Janjua

Larry S. Nichter, MD, MS, FACS · Answer

Although blepharoplasty surgery is the only treatment that is long lasting there are a few things you can do that are of temporary help. Make sure you have an exam to make sure that you do not have weak eye muscles, ptosis, as your cause by an exam by a board certified specialist. Lower lids: Ceramide creams for the lower lids which in minutes as they dry the clear membrane tightens the lower lid skin minimizing bags and wrinkles. This lasts from 4-8 hrs and can be reapplied as needed. Radiofrequency, laser and peels tighten the skin with minimal downtime. Fillers for fat transfer #lipoinjection, to the lower lid to fill in the cheek-lid depression that casts shadows also helps many. For the upper lids, Botox in the crows feet area just below the brow will gently lift the lateral brow and lift a bit of the hooding on the side of your eye. This lasts about 3-4 months. Make sure you go to an expert injector associated with a Plastic Surgeon, Facial Plastic Surgeon, Dermatologist, or Ophthalmologist skilled in injections.#NonSurgicalEyeliftAlternatives#NonSurgicalBlepharoplastyOptions

Leila Kasrai, MD, FRCSC · Answer

Botox or Dysport could help if the brow is pushing down on your eyes, causing the droopiness. However, you appear to be younger and this might not be effective. Either way, you should see a board certified plastic surgeon for an exam to determine what would help in your situation.

Richard J. Bruneteau, MD · Answer

Puffy
upper eyelids can occur for a variety of reasons. In the vast majority of cases
this problem is related to facial aging. Under these circumstances, puffy
eyelids are usually related to excess eyelid skin associated with prominent fat
pads. Unfortunately, there are no non-surgical methods available for the
removal of eyelid fat. Correction of this problem usually requires
blepharoplasty surgery.

In
other patients, puffy eyelids may be inherited and related to genetic factors.
When this occurs, blepharoplasty can be performed, but in most cases is not
indicated.

Finally,
puffy eyelids may be related to neither conditions that effect the upper
eyelids secondarily. For example, premature brow descent might cause the
eyelids to look puffy. Unfortunately, correction of this problem would also
require surgical intervention.

Patients
with allergies may also develop puffy eyes. Under these circumstances,
treatment of the allergies may avoid surgery.

Surgery
is indicated in the vast majority of patients who have puffy eyelids because of
upper eyelid fat. Sometimes eye makeup can help hide this problem, but severe
deformities usually require surgery. If you’re concerned about this issue,
consultation with a board certified plastic surgeon is appropriate.

Nelson Lee Novick, MD · Answer

The Ten Minute Eyelift, which I developed about six years ago, is a minimally-invasive, minimal downtime procedure for permanently improving hooded upper lids (i.e. those upper lids that drape over the true upper lid and hide it). If this is the problem that you are describing then the Ten Minute Eyelift may be appropriate with or without the addition, if necessary for further correction, of Botox, Dysport or Xeomin and fillers, such as Juvederm UltraXc, to further elevate the brow.

	The procedure is quite simple, is performed under local anesthesia, and most people may return to their regular routines within a day or two. I performed the procedure on myself about six years ago and actually took a ten hour international flight the following day. For more details on what the procedure entails and how it is performed, I would suggest you check out the medical library of my website, YoungerLookingWithoutSurgery.com.

Mehryar (Ray) Taban, MD, FACS · Answer

Full upper eyelids and brows are a sign of youth.  Upper lid blepharoplasty can help if done conservatively. There are no nonsurgical techniques for that.

Leo Kim, FRACS(Plast), MS(Plast), MBBS(Hons) · Answer

There are energy sources (e.g laser) available to treat the skin in the upper eyelids but it will not address the excess fat which I can't see from your beautiful photo. This of course will have less of a change but maybe something you would consider if you can't afford 2 weeks of down time.
Wish you the best in your journey,
Dr Leo Kim, Specialist Plastic Surgeon in Sydney

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